Ethics Quiz: “Fixing” “Elf Ears”

6-year-old Gage Berger was being bullied by his first grade classmates because he had protruding ears, and was often derided as “Elf Ears.” His Salt Lake City parents decided to address the problem here and now, before, they say, his self-esteem (I almost wrote elf-esteem…) was permanently damaged, so they had his ears de-elfed to look like everyone else’s.

Now he’s bullying other funny-looking kids.

Kidding.

I hope.

But seriously, folks, the story has aroused a controversy over societal and medical ethics. Did the parents choose plastic surgery too early and for the wrong reasons? Is that how we want society to be, where bullies and critics can pressure individuals to conform to a narrow standard of acceptible appearance? Doesn’t this give them power? Does it not encourage bullying? Is a first-grader old enough to meaningfully weigh these issues? Isn’t this a choice he should make, when he’s old enough to make it?

Your Ethics Alarms Ethics Quiz for today is…

Was it ethical to clip Gary’s ears?

The New York Daily News interviewed psychologists and plastic surgeons, among other experts, about Gary’s parents’ decision.

“It is not unusual for a child to have ear surgery at a relatively young age,” said Dr. Tracy Pfeifer, a plastic surgeon, who specializes in facial plastic surgery.

That makes it ethical then, I guess! In addition to this obvious rationalization, she added, “The surgery is relatively simple and it is life-changing in a positive way for these young children.”

The fact that’s it’s simple surgery makes it responsible and right? How does she know that the life changing aspect is positive? She has no idea what Gary would be like if his parents took a different course. (My father was bullied constantly, and learned to box. He also learned never to give in to unethical authority, which became the defining theme of his life.) What if Barbara Streisand’s parents and Jimmy Durante’s parents had given them nose-jobs?

Then she said,

“While in an ideal world children would not be bullied, plastic surgeons know all too well that children with abnormal looking ears are bullied and made fun of in school and this has a tremendous negative impact on their self-esteem.”

Or it builds character.

I think plastic surgeons asked whether parents should have their children rush to plastic surgeons have a conflict of interest. What did the Daily News expect her to say? Steven J. Pearlman, MD, another facial Plastic and Reconstructive Surgeon, tells the paper that “It’s harder to make friends so they become socially stunted. They are also perceived as less intelligent by peers and even adults.”

Wow. Whatever did the human race do before the miracle of plastic surgery?

Before being led to the cookie cutter, children should be encouraged to resist the demands of the mob, peer pressure, and opposition to their individual characteristics. “It is concerning to use plastic surgery to stop bullying,” said Dr. Karen Caraballo, a Bilingual-Spanish Child and Family Psychologist.

I just read an essay about how male in our society “bully” women in to using weasel words: how about, instead of “concerning,” calling this wrong, doctor? Imagine the power Gary’s parents have given to aspiring bullies, the next generation of Donald Trumps. “We can make a kid change his face!“ As for Gary, he has been taught that it is crucial to conform, even if you have to go to a hospital to do it. He is now a servant to the desires of others. Will he be a leader? Will he have the courage to stand up for himself and others? You never know, but his parents responding to mere taunting with such early surgery doesn’t bode well.

The surgery is also premature, and thus unethical from a medical ethics standpoint, because at six no child’s adult appearance can be accurately predicted. Nor can a six year old make an informed decision about surgically changing his or her appearance at that age, though The Daily News found some dubious experts—as in “flacks for the plastic surgery trade”—to claim otherwise. Except in a case of serious deformity, the choice to radically change a child’s appearance should be made after the child has gained some understanding of the issues involved.

Paget Brewster, the stunning and vivacious actress who portrayed Emily Brewster on CBS’s “Criminal Minds,” was interviewed in a documentary about her prominent nose…

and why she never had it “fixed.” She said that she considered surgery many times as a teen (“I mean, It’s a big nose!”) and as an aspiring actress, but realized that “take away my big nose and I’m just another standard issue starlet.” As a teen, she said, her unconventional looks forced her to rely on her personality, energy and intelligence….and when she turned out beautiful anyway, she was glad that she had delayed her trip to the plastic surgeon, as it turned out, forever. Gary never got that chance.

My vote on this quiz is that Gary’s parents jumped down a particularly slippery slope that can lead no place good.

31 thoughts on “Ethics Quiz: “Fixing” “Elf Ears””

I agree, unethical to mess with the boy’s ears. In fact, it might even be a criminal assault against the boy. Have you ever put your hands behind your ears and forcibly flared your ears away from the side of your head, so that you could better hear some sounds coming your way? I have. It works. I hope the boy grows up to sue for a free opulent rest of his life, for having his hearing forcibly impaired.

All that bullying the boy received? That has more to do with envy of naturally superior hearing ability. But such bullying has been done for so long, by so many, the human race has evolved to embrace the excuse that the bullying is an instinctive reaction to “other-than-human” outward appearances. My extraterrestrial forefathers are really pissed off about this. You watch what YOU say, too, Extradimensional Cephalopod!

Trolling? Come on, Jack! You act as if I am some Johnny come lately. I have been around here enough not to be accused of that. But, If by trolling, you mean Gadfly, sure.
I just said cleft lip, not palate.
My point is that you want to make this black and white. It is not.
If a cleft lip is a deformity, you could say the same of elf ears (maybe). I think there are degrees.
If it were my kid, no surgery. I was hesitant about my kids tonsillectomy adenoidectomy. I just am surgery adverse.
But, I do not agree this is bright line and clear cut.
-Jut

The ears are pretty clear, no? The kid looks like Bing Crosby. The horror. Your suggesting that a clear deformity is the same as big ears (Hello, LBJ!) is distorting the issue.

From the cdc: Children with a cleft lip with or without a cleft palate or a cleft palate alone often have problems with feeding and speaking clearly, and can have ear infections. They also might have hearing problems and problems with their teeth.

Surgery is MANDATORY. Comparing a true birth defect to a purely cosmetic and even uncertain as to that ( the issue is what the face will look like when he grows up.) It’s kike giving a short kid hormone treatment before his growth spurt. So again, what was the point?

My point: “true birth defect” and “purely cosmetic.” Your words. You want bright lines. You make bright lines. Kant would likely describe your views as moral tyranny because you want to make every issue into a moral one without any regard for the fact that most issues are not moral issues.

I ask you: are pierced ears on a 2-year old immoral. I would never do it; I think it’s stupid. I think it is borderline unethical, but I believe that fixing ears for aesthetic reasons is better than piercing wars for aesthetic reasons.
And this is coming from someone who is descended from and familiar with big-eared people, all of whom have used it for their own good humor.
-Jut

I don’t make ANY issues moral ones. I don’t deal in morality. I deal in ethics. I make the issues that I deem ethical ones ethical ones. I certainly don’t make “every” issue into an ethical one, because, as you say, most are not. This one isn’t just about unnecessary cosmetic procedures, abuse of parental power, medical ethics, trading individuality for conformity—it’s also about empowering and yielding to bullies. That’s 5 ethics issues. I’m pretty sure Kant could see most of them.

Pierced ears on a 2-year old may be moral, but they are never ethical.

On this one I disagree. I can’t say exactly why, but I think this is OK. Maybe the relative ease of the surgery and the dramatic difference it makes is enough. I wouldn’t insist my child live with a mouth full of crooked teeth even if they were healthy and strong. If they can be straightened they probably should be. Maybe it shouldn’t matter, but since it does, appearances that can be improved are better improved.

Yes, what about lightening a kid’s teeth after they were exposed to tetracycline in the womb, giving them bright yellow teeth? The teeth themselves are otherwise perfect. Would that be ok?

I personally think this particular child is supercute, both pre-surgery, and after ear clipping, but I can see why they did it, even if I probably wouldn’t. Will Smith often talked about how his own ears, pre-surgery, were the bane of his existence. But who knows where he would be without them?

Assuming my child’s self-esteem was in the toilet, I would opt for surgery, after trying everything to try and improve my child’s outlook. Braces are a good example — so are dog bites. If my child had a horrible scar on her face, I would have plastic surgery done to improve her appearance.

That’s just bad parenting 101. You see this a lot with moms rewarding their daughters for being skinny, instead of just teaching them to be healthy. The kids end up having self-esteem problems created by their moms.

Well, no, but it’s still an ethically important observation. The more complicated a surgery, the more likely there are to be, well, complications. In other words, there were (comparatively) few medical risks involved.

That is something very relevant to an ethical analysis of the situation.

“While in an ideal world children would not be bullied, plastic surgeons know all too well that children with abnormal looking ears are bullied and made fun of in school and this has a tremendous negative impact on their self-esteem.”

Or it builds character.

While I fully agree that ear surgery was a gross overreaction, I would caution against the statement that bullying builds character. Rather, character is built to stand up to bullying. It is a deliberate, process, rather than a passive one. Left unchecked, bullying is a terrifying and destructive process. This ear surgery is giving in to the fear of bullying; it concedes that one must change according to the whims of others.

The proper response would be to reaffirm that the kid has a right to his ears, and a right to a harassment free life. Then, teaching this self respect, the kid will learn the confidence needed to advocate for himself, whether to peers, teachers, or administrators if necessary. Parents and role models need to support this development, or it will not happen, as evidenced by rampant weenyism today.

My ears did the same thing at that age, I was also bullied. My fathers response wasn’t to have them “fixed” but to tell me to stand up for myself. And while I wasn’t to start any fights I was to defend myself. Standing up for myself and fighting back ended the bullying.

Good for your Dad, Bill. We humans’ ears and noses grow for our entire lifetimes. (Part of the nose part of that is probably the Pinocchio Effect). My ears have grown, and I might have grown into mine, too, but none of that growth has yet resulted in improving my hearing up to an average ability. I blame autism – along with rock & roll music, jet engines, a loud family, and hyperproduction of mucus. (I never reacted to being called “snothead,” even when said to me as an insult, because it was just true.)